Based on coronary angiographic findings, surgical coronary artery bypass grafting is recommended for patients with: (1) Certain anatomic features of coronary lesions are signs of surgical coronary artery bypass grafting, regardless of the severity of clinical symptoms and the presence or absence of left ventricular insufficiency. Such anatomic features include: left main stem lesions, severe stenosis (greater than or equal to 70%) of the proximal segment of the anterior descending and proximal segment of the gyrus branches equivalent to left main stem lesions, and 3-vessel lesions. In patients with abnormal left ventricular function (left ventricular ejection fraction less than 50%), the postoperative benefit is more pronounced in those with these lesions. (2) Patients with severe stenosis of one or two vessels in the proximal segment of the anterior descending branch and abnormal left ventricular function (left ventricular ejection fraction less than 50%) or myocardial ischemia confirmed by noninvasive examination can benefit from surgical coronary artery bypass grafting. (3) Patients with multiple vascular lesions with left ventricular insufficiency can benefit from coronary artery bypass grafting, regardless of their symptoms. However, in patients with heart failure as the main symptom without severe angina, the benefit of coronary artery bypass grafting is uncertain. Patients with better myocardial contractility should be considered for surgery. (4) Coronary artery bypass grafting should be considered in patients with symptoms or objective evidence of myocardial ischemia that persists or progressively worsens despite adequate nonsurgical treatment. The main advantages of PCI are the relative ease of application, avoidance or reduction of general anesthesia, open heart, extracorporeal circulation, central nervous system complications and shorter recovery time. The disadvantage of PCI is early restenosis and inability to resolve multiple complete occlusions or diffuse stenotic lesions. CABG has the advantage of more durable and complete revascularization independent of the morphology of the obstructive atherosclerotic lesion. Overall, the more extensive and diffuse the coronary atherosclerosis, the more CABG should be chosen, especially in cases of left ventricular insufficiency. Many CABG studies fail to reflect the results of current surgical practice. Currently, arterial bypass grafts are mostly used whenever technically feasible for the surgeon, with a 10-year patency rate of >90%. Nonstop bypass surgery is also used in selected patients, thus reducing complications.